Reopening A Nevada Worker’s Compensation Claim
Many injured workers wonder if they can reopen their Nevada industrial injury claim for more medical treatment. Does it matter if they took a permanent partial disability lump sum award?
Nevada law provides that under certain circumstances, injured workers can seek to reopen their worker’s compensation claim. NRS 616C.390(2) provides that after a claim has been closed, the insurer, upon receiving an application and for good cause shown, may authorize the reopening of the claim. The application must be accompanied by a written request for treatment from the physician or chiropractor treating the injured worker, certifying that the treatment is indicated by a change in circumstances and is related to the industrial injury sustained by the injured worker.
The injured worker has the burden of proof to show that the industrial injury claim should be reopened. NRS 616C.390 further provides that if the application to reopen a claim is made by the injured worker in writing more than one year after the date on which the claim was closed, the insurer shall reopen the claim (1) if a change of circumstances warrants the reopening, (2) the primary cause of the change of circumstances is the industrial injury, and (3) the application is accompanied by the certificate of a physician or a chiropractor showing a change of circumstances which would warrant reopening.
Now if an application to reopen a claim is made in writing within one year after the date on which the claim was closed, the insurer shall reopen the claim if (1) the application is supported by medical evidence demonstrating an objective change in the medical condition of the injured worker and (2) there is clear and convincing evidence that the primary cause of the change of circumstances is the industrial injury.
While many injured worker are entitled to lifetime reopening under the current law, there is a time limit on some injured workers in Nevada. An application to reopen a claim must be made in writing within 1 year after the date on which the claim was closed if the injured worker did not meet the minimum duration of incapacity as set forth in NRS 616C.400 as a result of the industrial injury and the injured worker did not receive benefits for a permanent partial disability.
It is very important for an injured worker to seek the legal advice of a qualified worker’s compensation attorney when requesting reopening for several reasons. First, the lawyer can make sure that it is done properly. The lawyer can review the doctor’s report to make sure it has addressed all elements of reopening. Second, if reopening is denied by the insurer, then the injured worker can appeal the determination to the Hearings Officer of the Department of Administration. The attorney can represent the injured worker at the hearing. Finally, NRS 616C.392 provides that if an injured worker applies for reopening and a final determination denying the reopening is issued, the injured worker cannot reapply to reopen the claim until at least one year after the date on which the final determination was issued. An injured worker does not want to fall into that trap.
There are many other laws and issues dealing with the topic of reopening. This article is meant to give a basic idea of some of the issues and laws. The requirements surrounding reopening of an industrial injury claim is another reason that every injured worker in Nevada should seek out and retain a qualified and experienced Nevada workers compensation attorney so that things are done properly from the beginning.
I hope that this has been helpful and informative. Please read the other blogs for more free, valuable information.
Joel A. Santos, Esq., is a Nevada worker’s compensation attorney. He is certified by the State Bar of Nevada as a Worker’s Compensation Expert and Specialist.
Copyright 2021 - Joel A. Santos, Esq.